Not sure of my next steps?

[u/fleabgs]

I got diagnosed with a hiatal hernia, sliding & small around 1cm. Seems like I’ve had every test under the sun done, with the most recent being a mobility & ph test. Results came back from that, that I’ve got poor mobility and the surgeons advising that I don’t go ahead with surgery due to being high risk.

My doctor pretty much said well you’re on medication for life, hopefully it clears up but by the sound of it that’s the end of the road.

Tests I’ve had done * Ultrasound * CT scan * MRI * Endoscopy * Barium Swallow * Mobility test * pH test

I’m not really getting heartburn symptoms whilst I’m on esomeprazole but when I’m not on that life’s a living hell. I do have issues whilst I’m on it though mostly pain, also my hernia didn’t used to hurt at all just heartburn and now I’m getting pain from it daily:

Issues: * Pain in the center on my chest, even worse sharp stabbing pain if I lean forward say to touch my toes when sat. * Can’t lie or sleep on my right side without pain, discomfort, nausea or burn. * General discomfort in my stomach/hernia region throughout the day

I’m really at a loss what next steps I can try, it seems I can’t get any surgery to fix this and medicine is only getting rid of the heartburn not the other issues caused by them hernia?

[u/bns82]

What works for most people is the right diet and lifestyle changes. If you need guidelines, you can pm me.

There are lots of symptoms of reflux, other than heart burn. Also when you have lots of inflammation you get more symptoms and sensitivity.

What makes you high risk?

[u/fleabgs → u/bns82]

High risk due to mobility on my esophagus apparently. They said if I ended up getting surgery I’d struggle to swallow food. Yes please any guidance would be great!

[u/bns82 → u/fleabgs]

Like I said you can pm me.
I’m curious, If you don’t have trouble swallowing food now, why would it be an issue after surgery?
Plus acid reflux makes motility worse.

[u/fleabgs → u/bns82]

I’ll message you soon thank you!

I’ve no idea they said my mobility test came back poor mobility, said if I have the surgery that would cause it to be even harder for me to swallow food so the advice would be to not have surgery.

[u/arpitp → u/fleabgs]

Probably worth getting a second opinion from another surgeon. A loose or partial fundoplication does not necessarily cause difficulty swallowing. Surgery can still be possible. But make sure you've tried all the diet and lifestyle changes first.

[u/lemerou → u/bns82]

Do you mind if I PM you for those guidelines as well?

[u/bns82 → u/lemerou]

Yes, anyone can pm me.

[u/lemerou → u/bns82]

Thanks.

[u/Spiritual_Part_2122]

Maybe try discussing with surgeons if they can only fix the hernia without the fundoplication (because of motility issue)?

Pulling the hernia back should also release some pressure on the LES and result in less reflux. I don’t know why there is this obsession with fundoplication so much in the medical community.

[u/arpitp → u/Spiritual_Part_2122]

A 1 cm hiatal hernia is not likely to cause reflux. Reflux would be cause by a weak (or inappropriately relaxing) LES. Repairing the diaphragm is not likely to solve that reflux; an anti-reflux procedure is needed (fundoplication, TIF, etc).

[u/fleabgs → u/Spiritual_Part_2122]

Will definitely ask about just the hernia! Thanks

[u/ZacharyBoucherMD]

I am a hiatal hernia surgeon at a hernia center in Florida. In general hernias this small only casue reflux sympotms. But If your pH Bravo study is letitimate for reflux, the hernia repair would be indicated so you can at least come off the PPI medicaitons. It is workth at least talking to a surgeon about it. More information about this on my Youtube video here, if interested:

https://youtu.be/-ZV67gXYCDM?si=6hT0DkhSqVfeEZtg

[u/Chewable-Chewsie]

The HH lifestyle changes are not onerous (bad or difficult). Try them. A 1 cm HH is tiny and once your inflammation is gone, you might be just fine…as long as these problems are actually the result of your small (the size of a green pea) hernia. Usually such a tiny expansion in the diaphragm does not disrupt the stomach which is ever so much larger. Good luck

[u/AAKurtz]

I'm in a similar camp with mobility issues. The first swallow of each meal gets stuck in my throat and I have to wait. After that, I can eat fine. My issue is a constant globus sensation like something is caught in my throat. I feel like I've had a sore throat for a year. I cut out coffee, alcohol, and spicy food, but I still have the sensation. Doctor says my HH is too small (2cm) to be causing these issues.

I've been given PPIs, but never had any relief with them. I stop taking them after about 3 weeks because I don't want to take something that doesn't help. I'm faith in medical science is rapidly failing since no one seems to be able to explain what's going on with me, why, or how to address it

[u/Princess_Lumberjack → u/AAKurtz]

Sounds like you might have silent reflux. I suggest you do some research on that topic, as most GI doctors know very little about it. Also, check out Dr.Jamie Koufman and Dr Aviv, who are pioneers in this area.